I found an old post which freaked me out on medhelp where a neuro talks about the significance of contraction fasciculations. Can someone weigh in here? The reason I ask is because my tongue only twitches when it's "activated" that is it is not sitting on the floor of my mouth. What is meant by contraction fasciculation? Please please help I'm in a panic

have no idea about contraction fasciculations, but for BFS it is practically typical to have twitches evoked by muscle activity. So does yout tongue. Are you sure you did not take normal tongue movements for fascics? it often happens for our fellows.

and please do not read medical articles. If you are not a dcotor, you most probably would misinterpret it and add more fears to your list.

These are definitely fasciculations. Has been verified by others on this board and an online doctor. The thing is, lately two spots have been going at once giving it that dreaded wormy look (at least to me). I have been reassuring myself by the mere fact that these terrible tongue movements go away when my tongue is completely relaxed, but have just recently discovered this thing called contraction fasciculations: fasciculations occurring in contracted muscle. Although, it's hard for me to know anything anymore. I hear tongue fascics must be examined at rest for two possible reasons 1) some tongues fasciculate on protrusion and 2) it's hard to see fascics on protrusion. So, I don't know which is true. All I know is that I can invoke my tongue twitches by moving the muscle which means they have FPs or something? I don't know. Im just really struggling....AGAIN.

Really, you ask people and ONLINE doctors to check you - you said it is not ethical without a physical exam..? Anyway, I do not want to argue, but neither want I to help you. Follow your own advice - see a doctor in personal, not anonymous posters.Take care,Docen

Last edited by TwitchyDoc on September 16th, 2014, 9:12 am, edited 1 time in total.

Nevill,I mean - if you have any troubles, it is better to go to a person who a) may see you in person not online: b) had at least 10 years of special education and some years of field experience

there would be much more chances that this person can interpret your tongue status better than we, who do not see you and often lack of medical knowledge, or than you can do it on the basis of the papers read in the internet.we have here even a medical persons full of fears, what to say about non-medicals

what I can say on the basis of multiple reports posted on this board is that tongue muscle contractions are not rare and if they are not accompanied by deeper neurological troubles, especially those rapidly increased in number and profoundness, then they are the same as other BFS fasciulations...

Again, I wasn't saying that what you have to say on this board isn't helpful (in fact, I've defended your position in this regard); rather, I was saying that you just need to be a bit more careful when you give the non neuros here anecdotal info that isn't available to us on Google (unless we know what we are looking for).

If you really want to respond to my post telling me how you are not going to tell me what this thing that is obviously causing me a lot of pain right now, then I guess that's on you. Either way, thanks for the response.

You are right. The reason I have resorted to online doctors and forums is because I'm desperate and I'm currently not covered by any health insurance (my insurance kicks in October 1st). So, being here in the States, you absolutely CANNOT see a neuro without any sort of health insurance. The best you could do is to go to the ER, and have a resident who will tell you to see a neuro when you can. So that's why I'm lost and jumping around online. As you can imagine, this is hell on earth.

Neville86 wrote:If you really want to respond to my post telling me how you are not going to tell me what this thing that is obviously causing me a lot of pain right now, then I guess that's on you. Either way, thanks for the response.

You think that your comments about me causing only harm and posting BS did not hurt me? Maybe now you get the feeling.

Alright, I am not going to be an idiot (though I was said to be).

Contraction fasciculations result from enlarged motor units, i.e. after denervation, the healthy nerves supply also the bundles that lost innervation. But then of course, activation of one unit causes activation of these "additional" units too.

But this is not observed in the tongue, I can assure you (when it is, you could hardly talk). Tongue displays fasciculatory movements when not held still, these are not contraction fasciculations. This is why it is so important to hold it absolutely still during the exam, because of the possible confusion.

Added from my smartphone:The fact that your fasciculations disappear once your tongue rests proves there is no nuclear or infranucleal lesion. If ithere was, your tongue would ripple when rested. It is entirely normal for the tongue to fasciculate when slightly flexed - tongue is not a muscle, there are at total 8 muscles, many interlacing each other. Imagine you want to keep balanance holding 8 dishes: some will tremble if you move!Despite what you wrote about me, I do hate seeing people in anxiety and I hope this will finally help you understand. When my wife sticks out her tongue just a few millimeters, I swear it looks like a bag of worms. But it is silent when resting and that is what you are so interested in.

Last edited by TwitchyDoc on September 16th, 2014, 10:21 am, edited 3 times in total.

[. If ithere was, your tongue would ripple when rested. It is entirely normal for the tongue to fasciculate when slightly flexed - tongue is not a muscle, there are at total 8 muscles, many interlacing each other. Imagine you want to keep balanance holding 8 dishes: some will tremble if you move!

Docean,

Does this mean the entire surface of the tongue all the time when at rest

Dave, laypeople really should not try to asses tongue fasciculations. When you relax your tongue, it will show some movements. But they are very, very different from true fasciculations.And as discussed before, even true fasciculation in the tongue does not mean you have MND. I would have it otherwise, Matt (bobajojo) and others.

Stop checking your tongues if you have no bulbar problems, I think I cannot say more to this topic. Be happy you can talk, swallow, whistle.

TwitchyDoc wrote:Dave, laypeople really should not try to asses tongue fasciculations. When you relax your tongue, it will show some movements. But they are very, very different from true fasciculations.And as discussed before, even true fasciculation in the tongue does not mean you have MND. I would have it otherwise, Matt (bobajojo) and others.

Stop checking your tongues if you have no bulbar problems, I think I cannot say more to this topic. Be happy you can talk, swallow, whistle.

Docen

I was actually going to put at the bottom of my last post Docean you must be totally sick of talking about tongues lol. My tongue doesnt ripple at all at rest but 4 or 5 times a day i get the up and down twitch at the tip which i have seen at rest but only in that spot, thats why i was asking is it the all over surface rippling look that is the nasty stuff and not what i described.